Active NPI
Cecelia Mary Vanover, LCPC
- Professional Counselor
- Shorewood, IL
National Provider Identifier
1467542829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 410 Shady LN
Shorewood, IL 60431-9782 - Phone
- (815) 741-1487
- Fax
- (815) 741-1487
- NPI assigned
- Oct 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | IL | Primary |
Addresses
Primary practice location
410 Shady LN
Shorewood, IL 60431-9782
Mailing address
410 Shady LN
Shorewood, IL 60431-9782
Phone (815) 741-1487
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9926911 | Other | IL | BCBS PROVIDER ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180-003384 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467542829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 SHADY LN",
"city": "SHOREWOOD",
"state": "IL",
"postal_code": "604319782",
"telephone_number": "815-741-1487",
"fax_number": "815-741-1487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 SHADY LN",
"city": "SHOREWOOD",
"state": "IL",
"postal_code": "604319782",
"telephone_number": "815-741-1487",
"fax_number": "815-741-1487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANOVER",
"first_name": "CECELIA",
"middle_name": "MARY",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER ID",
"identifier": "9926911",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shorewood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.